Mental Stress Ischemia: Characteristics, Pathophysiology, Prognosis and Treatment

  • M. M. Burg


Mental stress ischemia (MSI) is a recently recognized phenomenon defined by the occurrence of myocardial ischemia during the experience of mentally and/or emotionally stressful circumstances. A substantial research effort has been directed at improving our understanding of this phenomenon, and determining whether it has prognostic significance beyond that associated with the underlying, chronic coronary artery disease (CAD). This effort has also been directed toward determining whether it is possible to specifically treat this phenomenon, and whether treatment improves prognosis. In this chapter, I will first review the literature that describes this phenomenon, relying on both naturalistic and laboratory-based studies. I will then describe the research conducted on the pathophysiology that might underlie MSI, and follow this by a review of the literature concerning prognostic significance and treatment. I will end with a discussion of future directions for research. Rather than provide a comprehensive review of the literature, this chapter will be selective in the literature discussed, the general aim being to inform the reader about MSI.


Myocardial Blood Flow Coronary Flow Reserve Mental Stress Mental Arithmetic Silent Myocardial Ischemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • M. M. Burg
    • 1
    • 2
  1. 1.Behavioral Cardiovascular Health and Hypertension Program Department of MedicineColumbia University School of MedicineNew YorkUSA
  2. 2.Section of Cardiovascular MedicineYale University School of MedicineNew HavenUSA

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